Candidate: Sue Anne Bell, PhD, FNP-BC is an early career nurse-scientist and disaster response nurse focused on improving health outcomes for older adults after community-level disruptions, specifically natural disasters. Dr. Bell's long-term career goals are to become an independent nurse-scientist who advances the science of aging specific to disasters and a national leader in gerontology, focused on building community resilience for older adults. The objective of this K23 mentored career development award is for Dr. Bell to become a successful independent investigator by carrying out a coordinated 5-year plan of training and research activities. Research Context: There is an unmet need for data that can explain health outcomes for older adults after disaster. The acute disruption of a disaster can exacerbate potential vulnerabilities for older adults, leading to a decline in function. With over 1,200 federally declared disasters in the last decade, there is a critical need for high-quality causal evidence that can preserve function and support for older adults after disasters. Research Aims: The overall goal of this proposal is to unravel the mechanisms associated with hospitalizations after disasters among older adults in the US and translate that knowledge into actionable tools to support older adults prepare for and mitigate the harms of disaster. The specific aims are to: 1) Examine the relationship between exposure to a natural disaster and condition-specific hospitalizations among older adults, 2) Among a large sample of older adults, examine the extent to which community resilience affects the likelihood of hospitalization following a natural disaster adults and 3) Interview home health nurses to identify forms of additional individual and community-level support needed by chronically ill older adults after natural disaster to avoid hospitalization. Research Plan: To accomplish these aims, Dr. Bell will conduct analyses to measure hospitalizations after a subset of disasters among older adults, how community resilience affects individual hospitalizations, and understand how disasters affect older adults from the perspective of home health nurses. Career Development Plan: Through this research and training proposal, Dr. Bell will build upon her expertise in qualitative research and disaster response to develop expertise as a gerontology researcher with expertise in geospatial analysis and collecting data in hard to reach settings and populations. Dr. Bell's career development goals will be supported through intensive mentorship from an expert and personally committed team of mentors and national advisory board, advanced coursework, participation in the local and national scientific community, and progressively independent research. Environment: Dr. Bell's unique resources include a dedicated and accomplished multidisciplinary mentorship team with whom she has longstanding collaborations; the outstanding research infrastructure at the University of Michigan, which places an emphasis on supporting junior investigators; and strategically selected advanced courses and seminars delivered by several distinct academic units at the University of Michigan.